When psoriasis affects the feet, it often has an outsized impact on people’s quality of life. About 5 percent of people with psoriasis have palmoplantar psoriasis (PPP), plaque psoriasis on the feet (or hands) that can cause heavy scaling and cracking.
“Depending on its location, even a single lesion on the foot can affect people’s ability to do their day-to-day activities, causing significant discomfort and problems walking,” said Alan Menter, M.D., chair of the Department of Dermatology at Baylor University Medical Center in Dallas, Texas.
A 2014 study published in the Journal of the American Academy of Dermatology, for example, found that people with PPP scored lower on several quality of life measures than individuals with plaque psoriasis with higher total BSA scores whose feet weren’t affected.
Those with PPP were almost twice as likely to report mobility problems and almost two-and-a-half times more likely to have trouble doing their usual activities.
(Check out on our webinar for treating psoriasis of the hands and feet.)
Like all forms of psoriasis, appropriate medications are key to controlling PPP. But wearing the right footgear can also cut down on complications and up your comfort level and ability to take part in life.
If the shoe fits
Shoe selection is important, but socks come first, said Alex Kor, D.P.M., a podiatrist at Johns Hopkins Medical Center in Baltimore, Maryland.
“Cracking can be made worse by choosing the wrong socks—those that cause feet to sweat a lot, for example—and by not changing them enough,” he said.
Kor suggests 100 percent Merino wool socks or those made from blended materials to help wick away moisture.
“If your feet sweat a lot—which worsens dryness and cracking—it’s especially important to change socks after athletic activity and at mid-day, particularly if your job requires a lot of standing,” he said.
Shoes should have a roomy toe box to keep pressure off affected skin and nails, according to Kor.
“This means having enough depth from top to bottom, not just side to side,” he said, adding that heels should be no higher than 1.5 inches.
Kor also prefers a shoe with a rigid shank (the part of the shoe between the ball of the foot and the heel).
“A shoe should bend some at the ball of the foot, but not in the middle, where you need stiffness for stability,” he says.
In other words, if the shoe twists easily from end to end, pass!
Avoid flats, which provide little support, said Menter. “Cushioning reduces pressure,” he explained. “Insoles can also add to cushioning and comfort.”
A podiatrist or other foot specialist can prescribe insoles or modify shoes to target your individual foot issues.
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